Primorac Dragan, Molnar Vilim, Matišić Vid, Hudetz Damir, Jeleč Željko, Rod Eduard, Čukelj Fabijan, Vidović Dinko, Vrdoljak Trpimir, Dobričić Borut, Antičević Darko, Smolić Martina, Miškulin Mladen, Ćaćić Damir, Borić Igor
St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia.
Eberly College of Science, The Pennsylvania State University, University Park, State College, PA 16802, USA.
Pharmaceuticals (Basel). 2021 Mar 2;14(3):205. doi: 10.3390/ph14030205.
Osteoarthritis is the most common musculoskeletal progressive disease, with the knee as the most commonly affected joint in the human body. While several new medications are still under research, many symptomatic therapy options, such as analgesics (opioid and non-opioid), nonsteroid anti-inflammatory drugs, symptomatic slow-acting drugs in osteoarthritis, and preparations for topical administration, are being used, with a diverse clinical response and inconsistent conclusions across various professional societies guidelines. The concept of pharmacogenomic-guided therapy, which lies on principles of the right medication for the right patient in the right dose at the right time, can significantly increase the patient's response to symptom relief therapy in knee osteoarthritis. Corticosteroid intra-articular injections and hyaluronic acid injections provoke numerous discussions and disagreements among different guidelines, even though they are currently used in daily clinical practice. Biological options, such as platelet-rich plasma and mesenchymal stem cell injections, have shown good results in the treatment of osteoarthritis symptoms, greatly increasing the patient's quality of life, especially when combined with other therapeutic options. Non-inclusion of the latter therapies in the guidelines, and their inconsistent stance on numerous therapy options, requires larger and well-designed studies to examine the true effects of these therapies and update the existing guidelines.
骨关节炎是最常见的肌肉骨骼退行性疾病，膝关节是人体中最常受累的关节。虽然仍有几种新药正在研究中，但目前正在使用许多对症治疗方法，如镇痛药（阿片类和非阿片类）、非甾体抗炎药、骨关节炎症状性慢作用药物以及局部给药制剂，不同专业学会指南中的临床反应各不相同且结论不一致。药物基因组学指导治疗的概念基于在正确的时间为正确的患者使用正确剂量的正确药物这一原则，可以显著提高患者对膝关节骨关节炎症状缓解治疗的反应。关节内注射皮质类固醇和透明质酸注射在不同指南之间引发了众多讨论和分歧，尽管它们目前仍用于日常临床实践中。生物治疗方法，如富血小板血浆和间充质干细胞注射，在治疗骨关节炎症状方面已显示出良好效果，极大地提高了患者的生活质量，尤其是与其他治疗方法联合使用时。指南中未纳入后几种治疗方法，且对众多治疗方法的立场不一致，这需要进行更大规模且设计良好的研究来检验这些治疗方法的真实效果并更新现有指南。
